Effect of Calcification Based on Computer-Aided System on CT-Fractional Flow Reserve in Diagnosis of Coronary Artery Lesion

Abstract

This study was to analyze the diagnostic value of coronary computed tomography angiography (CCTA) and fractional flow reserve (FFR) based on computer-aided diagnosis (CAD) system for coronary lesions and the possible impact of calcification. 80 patients who underwent CCTA and FFR examination in hospital were selected as the subjects. The FFR value of 0.8 was used as the dividing line and divided into the ischemic group ( FFR ≤ 0.8 ) and nonischemic group ( FFR > 0.8 ). The basic data and imaging characteristics of patients were analyzed. The maximum diameter stenosis rate (MDS %), maximum area stenosis rate (MAS %), and napkin ring sign (NRS) in the ischemic group were significantly lower than those in the nonischemic group ( P < 0.05 ). Remodeling index (RI) and eccentric index (EI) compared with the nonischemic group had no significant difference ( P > 0.05 ). The total plaque volume (TPV), total plaque burden (TPB), calcified plaque volume (CPV), lipid plaque volume (LPV), and lipid plaque burden (LPB) in the ischemic group were significantly different from those in the non-ischemic group ( P < 0.05 ). MAS % had the largest area under curve (AUC) for the diagnosis of coronary myocardial ischemia (0.74), followed by MDS % (0.69) and LPV (0.68). CT-FFR had high diagnostic sensitivity, specificity, accuracy, truncation value, and AUC area data for patients in the ischemic group and nonischemic group. The diagnostic sensitivity, specificity, accuracy, cutoff value, and AUC area data of CT-FFR were higher in the ischemic group (89.93%, 92.07%, 95.84%, 60.51%, 0.932) and nonischemic group (93.75%, 90.88%, 96.24%, 58.22%, 0.944), but there were no significant differences between the two groups ( P > 0.05 ). In summary, CT-FFR based on CAD system has high accuracy in evaluating myocardial ischemia caused by coronary artery stenosis, and within a certain range of calcification scores, calcification does not affect the diagnostic accuracy of CT-FFR.

Diagnostic accuracy of noninvasive fractional flow reserve derived from computed tomography angiography in ischemia-specific coronary artery stenosis and indeterminate lesions: results from a multicenter study in China

“…A previous study demonstrated that the diagnostic accuracy of CCTA was higher in patients with calcification scores <600 compared to those with calcification scores >600, with diagnostic specificity increasing from 44% to 90%, and NPV increasing from 50% to 83% ( 25 ). However, recent studies have shown that CT-FFR combined with other hemodynamic indices, such as flow shear stress and flow velocity, may avoid overestimating calcified plaque by CCTA ( 26 ). Indeed, the NXT subgroup study showed that the differences in accuracy, sensitivity, and specificity of CT-FFR were not statistically significant between each interval group, and that CT-FFR had the same diagnostic efficacy (AUC: 0.86 and 0.92, respectively) ( 27 ).…”

Retracted: Effect of Calcification Based on Computer‐Aided System on CT‐Fractional Flow Reserve in Diagnosis of Coronary Artery Lesion

“…This article has been retracted by Hindawi, as publisher, following an investigation undertaken by the publisher [ 1 ]. This investigation has uncovered evidence of systematic manipulation of the publication and peer-review process.…”